PROJECT SUMMARY Respiratory Therapists (RTs) are increasingly tasked to improve the quality of care provided for their patients on mechanical ventilation while controlling cost amidst a high workload. Challenges for the RTs include maintaining continuous awareness of patient-ventilator interactions, assuring compliance with best practice protocols, and providing efficient communication during shift changes. While new technology has been recently introduced to improve medical record documentation, there is a scarcity of innovative electronic tools that can improve compliance with best practices and communications in respiratory care. In Phase I of the grant we propose to build a hand-held, electronic platform called RT Assistant to provide continuous remote monitoring of ventilated patients. The device will provide real time management guidelines based on pathophysiology, guidance on patient safety and best practices and a standardized hand-off communication tool. The Phase I prototype is designed to evaluate the feasibility of the tool and its integration into an RT?s workflow. The features of Phase II will greatly assist the RT in improving patient care. RT Assistant will serve as a platform for future modular upgrades that will provide clinical decision support (CDS) tailored for respiratory care. In Phase I, we propose two specific aims. Aim 1 ? Create a prototype RT Assistant system: we will design and build small inexpensive dongles based on Internet of Things (IOT) technology that will transmit continuous data from ventilators and physiologic monitors where it can be accessed in real time by a mobile device containing the RT Assistant software. The software embedded in the mobile device will collect data and intuitively present it for a quick interpretation of the patient status. The software will interpret the data in view of best available evidence and highlight issues requiring corrective interventions. The software will contain a hand-off check list and provide real time updates based on the unit?s accepted best practice protocols. The RT Assistant will be able to display all ventilator and relevant physiologic data from all of their assigned, connected rooms. Aim 2 ? Evaluate effectiveness of RT Assistant in a simulated clinical environment: We will simulate an RT critical care environment using standard hospital equipment and spontaneous breathing test lungs. Five rooms will be simulated each with a unique clinical scenario. A series of RTs will perform ventilator/patient assessments with and without the RT Assistant to assess their ability to maintain LPV guidelines. After completion, the RTs will perform a shift change hand-off that will also be evaluated.